MEDICARE: DR. KENT E. NABERS PHD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	3083825-2501	UT

General Provider Information

NPI Number	:	1649248683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENT E. NABERS PHD.

Provider Business Mailing Address
First Line	:	265 NORTH MAIN STREET
Second Line	:	SUITE D #137
City	:	OGDEN
State	:	UT
Zip	:	84037-1424
Country	:	US
Telephone Number	:	801-476-6916
Fax Number	:	801-476-6990

Provider Business Practice Location Address
First Line	:	265 NORTH MAIN STREET
Second Line	:	SUITE D #137
City	:	KAYSVILLE
State	:	UT
Zip	:	84037-1424
Country	:	US
Telephone Number	:	801-476-6916
Fax Number	:	801-476-6990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	09/10/2020

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